JEFFERY P MENDELL (NPI# 1629285556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629285556 |
| Entity Type | Individual |
| Full Name | JEFFERY P MENDELL |
| Credential | MD |
| Practice Address |
350 N Wall St Kankakee IL 60901-2901 |
| Mailing Address |
1905 W Court St Kankakee IL 60901-3163 |
| Practice Telephone | 8159331671 |
| Mailing Telephone | 8159357525 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS ID | 4615054 | 01 |
| Street Address |
350 N WALL ST |
| City | KANKAKEE |
| State | IL |
| Zip Code | 60901-2901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710967955 | Yasser A Alhaj-hussein | Anesthesiology | 350 N Wall St, Dept of Anesthesesia, Kankakee, IL 60901-2901 | 2006-01-21 |
| 1932727229 | Elizabeth Ann Christian | Speech-Language Pathologist | 350 N Wall St, Kankakee, IL 60901-2901 | 2020-07-13 |
| 1649897471 | Taryn Mackenzie Linke | Speech-Language Pathologist | 350 N Wall St, Kankakee, IL 60901-2901 | 2020-06-27 |
| 1629693726 | Stephen Tulley | Internal Medicine | 350 N Wall St, Kankakee, IL 60901-2991 | 2020-06-15 |
| 1891310991 | Matthew Sutherland | Internal Medicine | 350 N Wall St, Kankakee, IL 60901-2991 | 2020-06-15 |
| 1962026302 | Kelsie Joann Jamilia Winger | Psychiatry & Neurology | 350 N Wall St, Kankakee, IL 60901-2991 | 2020-06-01 |
| 1346863321 | Ahmed Ismail | Internal Medicine | 350 N Wall St, Kankakee, IL 60901-2901 | 2020-05-25 |
| 1013539683 | Megan L Lucas | Pharmacist | 350 N Wall St, Kankakee, IL 60901-2991 | 2020-05-17 |
| 1568084523 | Alketa Zyka | Internal Medicine | 350 N Wall St, Kankakee, IL 60901-2901 | 2020-05-13 |
| 1134741028 | Shahzaib Khan | Psychiatry & Neurology | 350 N Wall St, Kankakee, IL 60901-2901 | 2020-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978841 | William Mitsos Dds | Dentist | 1291 S. 7th Ave, Kankakee, IL 60901 | 2020-09-30 |
| 1922653682 | Jody Mcguyer, Lcpc, Cadc Counseling Services, LLC | Counselor | 315 W. Court St., Kankakee, IL 60901 | 2019-08-08 |
| 1700346327 | Sarah Elizabeth Toma | Speech-Language Pathologist | 200 E Court St #708, Kankakee, IL 60901 | 2019-03-20 |
| 1710473160 | Small Talk Speech Services, LLC | Clinic/Center | 1439 W Vanmeter St, Kankakee, IL 60901 | 2018-07-09 |
| 1124538004 | Amy J Green | Physical Therapist | 350 N. Wall Street, Kankakee, IL 60901 | 2017-10-05 |
| 1013457514 | Elizabeth Ann Smith | Registered Nurse | 292 Charlton Lane, Kankakee, IL 60901 | 2017-03-02 |
| 1861931461 | Stacey E. Brown | Nurse Practitioner | 207 N. Schuyler Ave., Kankakee, IL 60901 | 2017-02-15 |
| 1417352105 | Provider Healthcare Services, Inc | Home Health | 555 South Schuyler, Suite 275, Kankakee, IL 60901 | 2014-10-24 |
| 1265850655 | Ronald George Testa | Dentist | 202 N. Schuyler Ave, Kankakee, IL 60901 | 2014-04-02 |
| 1245587898 | Mary Beth Wertz | Registered Nurse | 100 N Jeffery Street, Kankakee, IL 60901 | 2012-08-13 |
| Find all providers in zip 60901 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447593116 | Tyler Hall Cornelius | Radiology | 350 N Wall St, Kankakee, IL 60901-2901 | 2013-04-01 |
| 1548521883 | Supriya Gupta | Radiology | 500 W Court St, Kankakee, IL 60901 | 2012-06-04 |
| 1699900092 | Ravi Ramakrishna | Radiology | 350 N Wall St, Kankakee, IL 60901-2901 | 2009-05-28 |
| 1043381239 | Howard I Roth | Radiology | 350 N Wall St, Kankakee, IL 60901-2901 | 2006-11-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376196220 | Parvathamma Imaging Services, LLC | Radiology | 7431 S East End Ave Ste 2, Chicago, IL 60649-3611 | 2019-07-19 |
| 1730652017 | Diaspora Radiology, Sc | Radiology | 2602 Mulberry Ln, Northbrook, IL 60062-5937 | 2019-01-09 |
| 1225516842 | Tyler Jonathan Hinkel | Radiology | 33 W Ontario St Apt 46f, Chicago, IL 60654 | 2018-08-06 |
| 1043796543 | Quantum Medical Radiology of California, P.C. | Radiology | 374 W Seminary Ave, Wheaton, IL 60187-5002 | 2018-07-17 |
| 1215429501 | The Open Mri Center | Radiology | 3123 Williamson County Pkwy, Marion, IL 62959-5235 | 2018-06-01 |
| 1649769746 | Envision Medical Imaging, LLC | Radiology | 915 National Pkwy Ste 915-20, Schaumburg, IL 60173-5160 | 2018-05-03 |
| 1831687250 | Michael Patrick Murphy | Radiology | 807 Davis St. Unit 707, Evanston, IL 60201 | 2018-05-01 |
| 1366976631 | Ali Mostafa Serhal | Radiology | 240 E. Huron St, Suite 1-203, Chicago, IL 60617 | 2017-04-13 |
| 1710427737 | Dorothea A Nazos | Radiology | 1810 Parkside Dr, Shorewood, IL 60404-0684 | 2017-02-24 |
| 1194275941 | Florida United Radiology, Lc | Radiology | 7 Pear Tree Ct, Charleston, IL 61920-4415 | 2016-10-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.